In the age of high-deductible health plans, healthcare providers must change how they work with patients to get paid.
The bottom line, says Tim Ledbetter, former director of revenue cycle operations at Granger Medical Clinic serving the Salt Lake City region and now head of TDL Consulting, is that “providers need to be very wallet-oriented.”
That’s because, as Ledbetter will explain during a March 2 session at HIMSS16, if providers don’t get cash at the time of treatment or a commitment to pay via a credit card number they can deduct from after the explanation of benefit statement comes, they might never get the payment.
Many providers wait for payment until a claim has been processed and the EOB arrives. A patient still may be under a deductible and treatment will cost $200. But part of the treatment was covered, so the final bill turns out to be $179. If a card is on file, the provider can deduct the $179, saving time and money trying to get the money, and lowering risk.
So providers need to revamp how they talk with patients about payment, Ledbetter believes. “This promise to pay upfront is relatively new to the industry.” Providers need to help patients understand their benefits, the difference between estimated and final costs, ask if patients can pay in full today and get a 30 percent discount, or make other arrangements that give some assurance of payment—and do it at referral and scheduling times. Further, they have to treat every patient differently, looking at individual plans and deductibles and measuring the risk.
Understandably, providers are afraid that this tactic will compel patients to just find another doctor. What many providers don’t know, Ledbetter says, is that patients are more open than believed to pay after the claim is processed either via a card on file or another commitment.
“They know they have deductibles and have to make these payments. Software tools available today are much better and quicker in creating estimates. We can have these conversations much easier than in the past.”
The session, “The Perfect Plan for Prompt and Painless Payment Payments,” is scheduled on March 2 at 1 p.m. in Delfino 4004.
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